Cortical excitability and rest activity properties in patients with depression.

OBJECTIVE Results of recent studies suggest a link between neuronal excitatory or inhibitory unbalance and depression. To investigate this relation, we studied the rest activity and the cortical excitability of the cerebral areas dedicated to hand control in 12 patients with depression. METHODS Brain activity was recorded from the Rolandic region in both hemispheres of 12 depression patients and 11 control subjects by means of magnetoencephalography. We studied cortical excitability by focusing on the M20 and M30 components of the magnetic fields evoked by a stimulation of the median nerve. RESULTS Parietal rest rhythms showed greater total power in patients than in control subjects. In particular, the patient's parietal alpha was higher in the right than in the left hemisphere. Primary sensory cortex excitability, expressed by the M20, appeared significantly reduced in patients with depression, but was still higher in the right than in the left hemisphere. The M30 also appeared reduced, and this reduction was significantly correlated with both depression severity and global illness. CONCLUSIONS The patients studied were not completely drug free. For this reason, it is impossible to rule out the possibility that our results are an effect of drug assumption. Nevertheless, since all patients were well below the drugs' steady state levels when the data were recorded, the behaviour of M20 and M30 and their relation with the patients' clinical pictures suggest that an unbalance of the excitatory or inhibitory cortical activity, and especially a potentiation of the parietal afferent to the motor cortex, may be significant hallmarks of depression.

[1]  J. Krystal,et al.  Cortical gamma-aminobutyric acid concentrations in depressed patients receiving cognitive behavioral therapy. , 2006, Biological psychiatry.

[2]  V. Knott,et al.  EEG power, frequency, asymmetry and coherence in male depression , 2001, Psychiatry Research: Neuroimaging.

[3]  R. Davidson Cerebral asymmetry, emotion, and affective style. , 1995 .

[4]  P. Rossini,et al.  Short latency somatosensory evoked responses to median nerve stimulation in healthy humans: electric and magnetic recordings. , 1989, The International journal of neuroscience.

[5]  Á. Pascual-Leone,et al.  Interhemispheric asymmetry of motor cortical excitability in major depression as measured by transcranial magnetic stimulation , 2000, British Journal of Psychiatry.

[6]  L. Hirsch Competing interests: none declared. , 2006 .

[7]  J. Krystal,et al.  Cortical γ-Aminobutyric Acid Concentrations in Depressed Patients Receiving Cognitive Behavioral Therapy , 2006, Biological Psychiatry.

[8]  R. Davidson Anxiety and affective style: role of prefrontal cortex and amygdala , 2002, Biological Psychiatry.

[9]  M. Caligiuri,et al.  Motor and cognitive aspects of motor retardation in depression. , 2000, Journal of affective disorders.

[10]  N. Fox,et al.  Maternal depression, child frontal asymmetry, and child affective behavior as factors in child behavior problems. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[11]  M. Weissman,et al.  Electroencephalographic measures of regional hemispheric activity in offspring at risk for depressive disorders , 2005, Biological Psychiatry.

[12]  S. Starkstein,et al.  Quantified electroencephalographic changes in depressed patients with and without dementia , 1995, Biological Psychiatry.

[13]  R. Davidson,et al.  Frontal and parietal electroencephalogram asymmetry in depressed and nondepressed subjects. , 1983, Biological psychiatry.

[14]  R. Inzelberg,et al.  Changes in excitability of motor cortical circuitry in patients with parkinson's disease , 1995, Annals of neurology.

[15]  P. Rossini,et al.  Optimization of an independent component analysis approach for artifact identification and removal in magnetoencephalographic signals , 2004, Clinical Neurophysiology.

[16]  J. Yang,et al.  In vivo evidence for reduced cortical glutamate–glutamine cycling in rats treated with the antidepressant/antipanic drug phenelzine , 2005, Neuroscience.

[17]  Sarah H. Lisanby,et al.  Evidence for Impaired Cortical Inhibition in Patients with Unipolar Major Depression , 2006, Biological Psychiatry.

[18]  A. M. Aniss,et al.  Slowness of movement in melancholic depression , 1994, Biological Psychiatry.

[19]  B. Puri,et al.  Transcranial Magnetic Stimulation in Psychiatric Research , 1996, British Journal of Psychiatry.

[20]  J. Stephen,et al.  Sources on the anterior and posterior banks of the central sulcus identified from magnetic somatosensory evoked responses using Multi‐Start Spatio‐Temporal localization , 2000, Human brain mapping.

[21]  N. Fox,et al.  Frontal brain asymmetry predicts infants' response to maternal separation. , 1989, Journal of abnormal psychology.

[22]  N. Fox,et al.  EEG activation in 1-month-old infants of depressed mothers , 1997, Development and Psychopathology.

[23]  W. Klimesch EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis , 1999, Brain Research Reviews.

[24]  R. Davidson Anterior cerebral asymmetry and the nature of emotion , 1992, Brain and Cognition.

[25]  D M Tucker,et al.  Right frontal lobe activation and right hemisphere performance. Decrement during a depressed mood. , 1981, Archives of general psychiatry.

[26]  Richard A. Roemer,et al.  Quantitative EEG in elderly depressives , 2005, Brain Topography.

[27]  S. Pappatà,et al.  Left prefrontal glucose hypometabolism in the depressed state: a confirmation. , 1990, The American journal of psychiatry.

[28]  G F Mason,et al.  Glutamate and GABA systems as targets for novel antidepressant and mood-stabilizing treatments , 2002, Molecular Psychiatry.

[29]  C. Civardi,et al.  Transcranial magnetic stimulation and Parkinson’s disease , 2002, Brain Research Reviews.

[30]  B. Daniels,et al.  Cortical Excitability of Psychiatric Disorders: Reduced Post-Exercise Facilitation in Depression Compared to Schizophrenia and Controls , 2002, The Australian and New Zealand journal of psychiatry.

[31]  John H Krystal,et al.  Subtype-specific alterations of gamma-aminobutyric acid and glutamate in patients with major depression. , 2004, Archives of general psychiatry.

[32]  P. Flor-Henry LATERALIZED TEMPORAL‐LIMBIC DYSFUNCTION AND PSYCHOPATHOLOGY * , 1976 .

[33]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[34]  J. Bradshaw,et al.  Motor cortical excitability and clinical response to rTMS in depression. , 2004, Journal of affective disorders.

[35]  T. Bolwig Regional cerebral blood flow in affective disorder , 1993, Acta psychiatrica Scandinavica. Supplementum.

[36]  R. Davidson,et al.  Regional brain electrical asymmetries discriminate between previously depressed and healthy control subjects. , 1990, Journal of abnormal psychology.

[37]  Klaus P. Ebmeier,et al.  Reduced cortical excitability in depression , 1999, British Journal of Psychiatry.

[38]  R. Gerner,et al.  CSF GABA in normal subjects and patients with depression, schizophrenia, mania, and anorexia nervosa. , 1981, The American journal of psychiatry.

[39]  R. Hari,et al.  Neuromagnetic studies of somatosensory system: Principles and examples , 1985, Progress in Neurobiology.

[40]  R. Roth,et al.  GABA levels in CSF of patients with psychiatric disorders. , 1980, The American journal of psychiatry.

[41]  F. Quitkin,et al.  Abnormal cerebral laterality in bipolar depression: Convergence of behavioral and brain event-related potential findings , 1992, Biological Psychiatry.

[42]  J. P. Kline,et al.  Differential Resting Quantitative Electroencephalographic Alpha Patterns in Women with Environmental Chemical Intolerance, Depressives, and Normals , 1998, Biological Psychiatry.

[43]  Alberto Fernández,et al.  Increased occipital delta dipole density in major depressive disorder determined by magnetoencephalography. , 2005, Journal of psychiatry & neuroscience : JPN.

[44]  Franca Tecchio,et al.  Hand cortical representation at rest and during activation: Gender and age effects in the two hemispheres , 2006, Clinical Neurophysiology.

[45]  J. Stewart,et al.  Cerebral laterality and depression: differences in perceptual asymmetry among diagnostic subtypes. , 1989, Journal of abnormal psychology.

[46]  Karl J. Friston,et al.  Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions , 1993, Psychological Medicine.

[47]  N Accornero,et al.  Motor cortical inhibition and the dopaminergic system. Pharmacological changes in the silent period after transcranial brain stimulation in normal subjects, patients with Parkinson's disease and drug-induced parkinsonism. , 1994, Brain : a journal of neurology.

[48]  M. Kocmur,et al.  Evaluation of brain perfusion with technetium-99m bicisate single-photon emission tomography in patients with depressive disorder before and after drug treatment , 1998, European Journal of Nuclear Medicine.

[49]  G. Rizzolatti,et al.  The Cortical Motor System , 2001, Neuron.

[50]  Jeffrey B. Henriques,et al.  Left frontal hypoactivation in depression. , 1991, Journal of abnormal psychology.

[51]  R. Davidson,et al.  Depression: perspectives from affective neuroscience. , 2002, Annual review of psychology.